Questions raised about physio for hip osteoarthritis

Physiotherapy for hip osteoarthritis does not appear to relieve pain or increase function any more than ‘sham’ treatments, University of Melbourne research has determined.

Hip osteoarthritis is a prevalent and costly chronic musculoskeletal condition. Clinical guidelines recommend physiotherapy as treatment, although its effectiveness has never been proven.

Now, a study led by the University's Professor Kim Bennell has found that among adults with painful hip osteoarthritis, physical therapy does not produce greater improvements in pain or function compared with a placebo treatment.

In an article published in the prestigious Journal of the American Medical Association, Professor Bennell and her colleagues randomly assigned patients with hip osteoarthritis to attend 10 sessions of either active physiotherapy treatment (which included education and advice, manual therapy, home exercise and walking with an aid, if needed) or placebo treatments (which included inactive ultrasounds and gel).

“For 24 weeks after treatment, the physio group continued unsupervised home exercise while the placebo group self-applied gel three times a week,” said Professor Bennell.

"To our surprise, patient outcomes were roughly the same the 13 and 36 week intervals."

The treatment group actually reported a greater number of adverse events, although they were relatively mild.

“These results question the benefits of the specific physiotherapy components for this patient population,” according to Professor Bennell.

"We are currently conducting other trials to further examine the effects of other non-drug treatments for people with osteoarthritis to see whether benefits can be improved," she said.

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